{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:57Z","timestamp":1747196157950,"version":"3.40.5"},"reference-count":8,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Health inequalities based on race are well-documented, and the COVID-19 pandemic is no exception. Despite the advances in modern medicine, access to health care remains a primary determinant of health outcomes, especially for communities of color. African-Americans and other minorities are disproportionately at risk for infection with COVID-19, but this problem extends beyond access alone. This study sought to identify trends in race-based disparities in COVID-19 in the setting of universal access to care. Tripler Army Medical Center (TAMC) is a Department of Defense Military Treatment Facility (DoD-MTF) that provides full access to healthcare to active duty military members, beneficiaries, and veterans. We evaluated the characteristics of individuals diagnosed with SARS-CoV-2 infection at TAMC in a retrospective, case-controlled (1:1) study. Most patients (69%) had received a COVID-19 test within 3 days of symptom onset. Multivariable logistic regression analyses were used to identify factors associated with testing positive and to estimate adjusted odds ratios. African-American patients and patients who identified as \u201cOther\u201d ethnicities were two times more likely to test positive for SARS-CoV-2 relative to Caucasian patients. Other factors associated with testing positive include: younger age, male gender, previous positive test, presenting with &gt;3 symptoms, close contact with a COVID-19 positive patient, and being a member of the US Navy. African-Americans and patients who identify as \u201cOther\u201d ethnicities had disproportionately higher rates of positivity of COVID-19. Although other factors contribute to increased test positivity across all patient populations, access to care does not appear to itself explain this discrepancy with COVID-19.<\/jats:p>","DOI":"10.1371\/journal.pone.0263472","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T18:26:37Z","timestamp":1643999197000},"page":"e0263472","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persons tested for SAR-CoV-2 at a military treatment facility in Hawaii"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1351-7503","authenticated-orcid":true,"given":"Javier","family":"Barranco-Trabi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimmy","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kayatani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Mank","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Nesmith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Omara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7816-9525","authenticated-orcid":true,"given":"Louis","family":"Tripoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lustik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Masel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Chi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viseth","family":"Ngauy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"key":"pone.0263472.ref001","unstructured":"Coronaviruses [Internet]. National Institute of Allergy and Infectious Diseases. U.S. Department of Health and Human Services; [cited 2020Jun17]. https:\/\/www.niaid.nih.gov\/diseases-conditions\/coronaviruses"},{"key":"pone.0263472.ref002","unstructured":"Coronavirus disease (covid-19) [Internet]. World Health Organization. World Health Organization; [cited 2020May7]. https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019"},{"key":"pone.0263472.ref003","unstructured":"QuickFacts-Hawaii [Intranet]. United States Census Bureau; [cited 2020 July]. https:\/\/www.census.gov\/quickfacts\/fact\/table\/HI\/RHI425219"},{"key":"pone.0263472.ref004","unstructured":"Second Supplementary Proclamation Related to the COVID-19 Emergency. Governor of the State of Hawaii [Internet]. [Cited March 21, 2020]. https:\/\/governor.hawaii.gov\/emergency-proclamations\/page\/4\/."},{"key":"pone.0263472.ref005","unstructured":"Statement by the Department of Defense on Domestic Travel Restrictions. U.S. Department of Defense. [Online] March 13, 2020. [Cited: July 30, 2021.] https:\/\/www.defense.gov\/Newsroom\/Releases\/Release\/Article\/2112213\/statement-by-the-department-of-defense-on-domestic-travel-restrictions\/."},{"issue":"10","key":"pone.0263472.ref006","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1002\/pmrj.12454","article-title":"Screening Testing for SARS-CoV-2 upon Admission to Rehabilitation Hospitals in a High COVID-19 Prevalence Community","volume":"12","author":"SC Kirshblum","year":"2020","journal-title":"PM R"},{"issue":"6","key":"pone.0263472.ref007","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1097\/SLA.0000000000004218","article-title":"Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study","volume":"272","author":"CAJ Puylaert","year":"2020","journal-title":"Ann Surg"},{"issue":"3","key":"pone.0263472.ref008","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.cmet.2021.01.016","article-title":"Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning","volume":"33","author":"DJ Drucker","year":"2021","journal-title":"Cell Metab"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T18:26:47Z","timestamp":1643999207000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263472"}},"subtitle":[],"editor":[{"given":"Sanjay Kumar Singh","family":"Patel","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,4]]},"references-count":8,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0263472","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,2,4]]}}}